Burn Treatment

1
Burn Treatment Safety

• Nueces County
• Risk Management Department

2
Burns

• 70 of burn injuries occur in the home

3
Prevention

• Smoke alarms
• Candles (xmas)
• Pan placement on stoves
• Fire extinguisher
• Care around flammable products
• (gasoline, kerosene) Nephew
• Appliances off
• Fireplace and wood stoves inspected

4
Practice A Family Fire Drill

• Ladder for upstairs
• Baseball bat for windows
• Stickers on windows
• Plan an alternate escape route
• Meet outside at a designated place

5
House Fire Scenario

• You are in a bedroom, the door is closed, what do
  you do?

6
House Fire Scenario

• Drop to hands and knees (more toxic next to the
  floor)
• Crawl to door
• Feel door, knobIf hot, do not open
• Most deaths are from smoke inhalation

7
Burns

• Thermal
• Chemical
• Electrical

8
Thermal Burns

• Caused by
• Flames
• Hot objects
• Flammable vapor that ignites
• Steam or hot liquid
• (baby in Texas)

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Thermal Burns What To Do

• Stop
• Drop
• Roll

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Thermal Burns What To Do 2

• Remove smoldering, hot, or burned clothing
• Do not remove stuck clothing
• Remove jewelry if possible (necklace burn)

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Thermal Burns What To Do

• Make quick assessment
• Check ABCs
• It is appropriate to consider the following but
  dont waste time
• Determine depth of burn
• Determine extent of burn (rule of 9s
• Head 9 (18 child infant)
• One hand and arm 9
• Each leg 18 (14 child and infant)
• Front torso 18 (9 upper half, 9 lower half)
• Back torso 18 (9 upper half, 9 lower half)

12
Thermal Burns What To Do

• Rule of palm 1
• Use for scatter burns
• See physician for burns to face, hands, feet or
  genitals
• Circumferential burn? See physician
• Does victim have other medical problems?

13
Chemical Burns

• Caused by
• Acids (batteries)
• Alkalis (drain cleaners- often more extensive)
• Organic compounds (oil products)

14
Chemical Burns

• If substance is dry
• Brush off before rinsing with water
• Protect yourself
• After brushing off chemical, or after exposure to
  liquid chemical
• Rinse with water for 20/30 minutes or longer
• Remove contaminated clothing while flushing with
  water
• Final rinse? Use soap
• Burn may develop slowly

15
Chemical Burns 2

• Call poison control
• Cover with dry sterile dressing
• Do not try to neutralize a chemical
• (save label)
• Seek medical attention for all chemical burns

16
Electrical Burns

• Prevention
• Outlet covers
• Breakers
• Gadget for checking power
• Excessive number of power cords plugged in

17
Electrical Burns

• External burns may not be present
• May induce
• ventricular fibrillation (cardiac problems)
• Respiration problems
• Freeze due to muscle spasms

18
Electrocution

• Electricity travels along nerves and vessels
• Exits body where it is in contact with ground
• May have several exit sites
• Surface injury may be tip of the ice berg

19
Car Accident Involving Power Line

• What should you do first?
• Should you remove victim from the vehicle?
• What if you feel tingling in your legs?
• Should you try to remove downed wires or poles?
• (buried power line)

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Someone Has Made Contact with Power Inside Your
House

• What would you do first?
• Then
• Check ABCs
• Treat for shock
• Seek medical attention

21
What to do for Electrical Burns

• Once the power is off, Check ABCs
• Spinal injury from fall?
• Treat for shock
• Most are 3rd degree
• Cover with sterile dressing, elevate body part
• Seek medical attention (burn center)
• (combine / lift)

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Degree of Burns

• First-degree (superficial)
• Second-degree (partial thickness)
• Third-degree (full thickness)

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First Degree Burns (superficial)

• Affects outer layer of skin
• Redness, swelling, tenderness, pain
• Usually heals without scarring

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Care of First-Degree Burns

• Immerse in cold water (or other cold fluids or
  use cold, wet, cloths)
• At least 10 minutes
• Do not apply cold on burn covering gt20 of the
  body
• Aspirin or ibpuprofen
• Acetaminophen will not reduce inflammation
• Bacitracin (no other OTC products)
• Aloe vera , moisturizer lotion
• Dressing?
• Drink plenty of water
• Protect burn from friction or pressure

25
Second Degree Burns (partial thickness)

• Extends into the inner layer of skin
• Blisters, swelling, weeping, severe pain

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Care of Second Degree Burns

• Immerse in cold water / wet pack
• Aspirin or ibuprofen
• Drink plenty of water
• Apply bacitracin or Silvedene (do not use home
  remedies)
• Cover burn with non-sticking dressing
• If burn is extensive
• Treat for shock / seek medical attention
• Do not break blisters
• Hot tar on lip
• Medical help required 10 of adult burned, 5
  child

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Third Degree Burns

• Extends through skin, muscle and bone -Nerve
  endings are destroyed
• Discoloration
• Area larger than a half-dollar requires tissue
  removal and grafting to properly heal

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Care of Third Degree Burns

• Usually not necessary to apply cold to areas of
  third degree
• If more than 20 of body is burned, do not
  immerse
• Do not apply ointments
• Apply sterile, non-stick dressings (do not use
  plastic)
• Check ABCs
• Treat for shock
• Medical help
• (radiator burn)

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Sunburn

• Usually 1st degree, sometimes 2nd degree
• Cool compresses
• Drink plenty of fluids
• Fever / chills
• Use lotions, bacitracin (lake, snow skiing, lips,
  ears)
• Prevention
• Sunscreen SPF 30 has only 3 gt protection than
  SPF 15
• Skin cancer

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Respiratory Tract Burns

• All must receive medical care
• Nose to trachea receives brunt of the burn
• Swelling may appear in 2 to 24 hours
• Chlorine
• Add to water
• Wall paper removers
• Bathroom cleaning agents (chemistry set)
• Use products in well ventilated area
• Dont mix ammonia and bleach
• Toilet bowl flushes

31
Other Moderate to Severe Burns Requiring Medical
Care

• Under 5 years old / over 55
• Breathing difficulties
• Other injuries
• Electrical injury
• Suspected child abuse (teacher liability)
• 2nd degree gt10 of body
• Third degree